Double Plating Fixation vs Distal Femoral Replacement in the Management of Distal Femoral Fractures in Geriatric Patients.

Autor: Gendya AGMK; Department of Orthopaedic surgery, Ain Shams University, Cairo, Egypt., El-Zaher EH; Department of Orthopaedic surgery, Ain Shams University, Cairo, Egypt., Zakaria ZM; Department of Orthopaedic surgery, Ain Shams University, Cairo, Egypt., Awad MES; Department of Orthopaedic surgery, Ain Shams University, Cairo, Egypt., Metwaly RGEA; Department of Orthopaedic surgery, Ain Shams University, Cairo, Egypt.
Jazyk: angličtina
Zdroj: Arthroplasty today [Arthroplast Today] 2023 Mar 14; Vol. 20, pp. 101113. Date of Electronic Publication: 2023 Mar 14 (Print Publication: 2023).
DOI: 10.1016/j.artd.2023.101113
Abstrakt: Background: Distal femur fractures are considered challenging to manage, particularly in geriatric patients. Double plating (DP) is a technique that helps with earlier rehabilitation and return to preinjury level of activity. Distal femoral replacement (DFR) is an alternative technique in the management of these fractures that may help to solve problems like associated knee osteoarthritis, osteoporosis, and severely comminuted condyles. The current study compares the functional and radiological outcomes of DFR and DP in the management of these fractures among geriatric patients.
Methods: This randomized, comparative, interventional study was performed at a university hospital. A total of 30 patients who underwent DFR or DP after distal femur fractures (AO/OTA 33 A3, 33 C) were analyzed. The primary outcome was Knee Society Score (KSS), whereas secondary outcomes included postoperative complications rate, knee range of motion, reoperation rate, and operative time.
Results: No significant difference was observed between DFR and DP except for the knee component of the KSS at a 12-month interval ( P  = .03) and knee range of motion at a 12-month interval ( P  = .001), both of which were in favor of DP. No significant difference in postoperative complications ( P  = .06), reoperation rate ( P  = 1.00), or operative time ( P  = .06) was noted.
Conclusions: DFR and DP had comparable functional (KSS) and radiological outcomes with no significant difference in postoperative complications, reoperation rate, or operative time.
(© 2023 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons.)
Databáze: MEDLINE